Upper and lower respiratory tract infections by human enterovirus and rhinovirus in adult patients with hematological malignancies

Am J Hematol. 2007 Sep;82(9):807-11. doi: 10.1002/ajh.20974.

Abstract

The impact of human enterovirus (HEV) and human rhinovirus (HRV) respiratory tract infections in adult patients with hematological malignancies has been infrequently reported. We retrospectively studied 31 patients with an upper or lower respiratory tract infection (URTI/LRTI) by HEV (n = 18) or HRV (n = 15). At onset, a LRTI was present in 6 (33%) and 2 (13%) episodes of HEV and HRV infections, respectively, with or without an URTI. Progression to LRTI (pneumonia) from prior URTI was seen in 1 (6%) and 2 (13%) HEV and HRV infections, respectively. The presence of lymphocytopenia (<0.5 x 10(9)/l) was higher in LRTI by HEV: 4/5 (80%) versus 2/10 (20%) by HRV. Eight of 18 (44%) patients with immunosuppression versus 3/14 (21%) patients with no immunosuppression at the onset of respiratory infection developed a LRTI. Thirteen per cent of patients had associated respiratory infections from bacteria, aspergillus, or CMV. Pulmonary aspergillosis was diagnosed in 20% of HRV infections. Three of 11 patients (27%) with a LRTI died, but pulmonary copathogens were also involved in all cases. In conclusion, HEV and HRV can be associated with LRTI in immunocompromised patients, although their direct impact on mortality is uncertain.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aspergillosis / complications
  • Aspergillosis / diagnosis
  • Aspergillosis / mortality
  • Bronchoalveolar Lavage Fluid / virology
  • Cytomegalovirus Infections / complications
  • Cytomegalovirus Infections / diagnosis
  • Disease Progression
  • Enterovirus Infections / drug therapy
  • Enterovirus Infections / epidemiology
  • Enterovirus Infections / virology*
  • Female
  • Hematologic Neoplasms / complications*
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Humans
  • Immunocompromised Host
  • Lung / microbiology
  • Lung Diseases, Fungal / complications
  • Lung Diseases, Fungal / diagnosis
  • Lung Diseases, Fungal / mortality
  • Male
  • Middle Aged
  • Picornaviridae Infections / drug therapy
  • Picornaviridae Infections / epidemiology
  • Picornaviridae Infections / virology*
  • Respiratory Tract Infections / complications
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / virology*
  • Retrospective Studies
  • Rhinovirus / isolation & purification*
  • Seasons
  • Survival Analysis
  • Transplantation, Autologous
  • Treatment Outcome